#74 • August 2017
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Cover: James Morrison Correspondence: Please send all correspondence to The Editor at PO Box 782, Kent Town, SA 5071, or email editor@hepatitissa.asn.au. Editor: James Morrison
Street Address: 3 Hackney Road, Hackney Postal Address:
PO Box 782 Kent Town SA 5071
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www.hepsa.asn.au admin@hepatitissa.asn.au
HEPATITIS SA BOARD Chair Arieta Papadelos Vice Chair Bill Gaston Secretary Lindsay Krassnitzer Treasurer Sam Raven Ordinary Members Catherine Ferguson Ratan Gazmere Kirsten Hicks Nicci Parkin Kerry Paterson (EO) Sharon Jennings Jeff Stewart
Contents 1 Liver Research 2 Hep B & Primary Care
4 Australia Leads World in HCV Treatment 7 Hepatitis E(urope) 8 LiverBetterLife: Living Books 10 Prison & BBVs 12 World Hepatitis Day 14 In Our Library 16 What’s On
Disclaimer: Views expressed in this newsletter are not necessarily those of Hepatitis SA. Information contained in this newsletter is not intended to take the place of medical advice given by your doctor or specialist. We welcome contributions from Hepatitis SA members and the general public. SA Health has contributed funds towards this program.
Grow Your Own
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he 1982 classic film Blade Runner, set in Los Angeles in 2019, brought to life a world in which artificial humans could be engineered entirely in a lab. While the real world hasn’t quite caught up with this, researchers in Melbourne’s St Vincent’s Institute of Medical Research (SVI) O’Brien Institute Department are working to develop lab-grown liver ‘organoids’ to help those affected by liver disease. In 2016, Dr Geraldine Mitchell and her long-time colleague Professor Wayne Morrison were awarded a grant to fund the development of what they call a ‘liver in a dish.’ The ultimate aim of their work is to grow an ‘organoid’ derived from a patient’s own cells, to be used as a source of tissue for liver transplantation. “The only current treatment for advanced liver disease is transplantation and because there are not enough organs to meet demand, many patients die before they can get a transplant,” Dr Mitchell explained. Her research involves a multi-disciplinary
Creating tiny livers in a petri dish team, including researchers and surgeons, whose focus is on using human cells to ‘grow’ a liver that could be up-scaled in the future to be used for transplantation, or as a platform on which to test drugs to treat disease. She explained that without the involvement of surgeons at St Vincent’s Hospital, and in particular, her PhD student, Surgical Fellow, Dr Kiryu Yap, the project would not be viable. “Kiryu is often called, both in and out of hours, to collect liver tissue from patients having surgery who have agreed to us using very small segments of their liver for our experiments. For this project, access to human cells is paramount.” Dr Yap said that one of the major hurdles is the need for cells in the organoid to get enough oxygen. The team are approaching this problem by engineering a vascular system for the tissue, derived from human support cells that can form blood vessels and secrete growth factors to help liver development.
Other components include a porous scaffold that provides a physical support upon which the cells can grow, and a special gel, which provides other factors that promote the cells’ survival. Ultimately, the team intend to use stem cells from a person with liver disease to grow liver tissue for transplantation. Dr Mitchell said that this is the most clinically feasible method to generate the millions of liver cells that would be required for personalised organoid generation. Liver organoid transplant surgeries to treat liver disease are still a number of years away. This is primarily because of the time required to ensure relevant steps such as up-scaling, safety screening, and many further experiments are rigorously completed and optimised before contemplating clinical use. Anyone who is interested in this research project should keep abreast of emerging liver disease treatments and transplant opportunities through their GP or liver specialist.
Further reading: Yap KK, Dingle AM, Palmer JA, Dhillon R, Lokmic Z, Penington AJ, Yeoh GC, Morrison WA, Mitchell GM, Enhanced liver progenitor cell survival and differentiation in vivo by spheroid implantation in a vascularized tissue engineering chamber, Biomaterials. 2013 May;34(16):3992-4001.
August 2017 • HEPATITIS SA COMMUNITY NEWS 74
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Begone, Hep B
How Primary Care can make a difference With World Hepatitis Day having just taken place, we thought it would be timely to hear from Assoc Prof Jill Benson AM, ModMed Medical Educator, about how important primary care is in the fight to eliminate hepatitis B.
W
hen I was training to be a doctor over 40 years ago, hepatitis B was called the ‘Australia antigen’. During my early career it was regarded as a ‘rare’ illness that either was thought to remain dormant in those who were ‘healthy carriers’ or caused cirrhosis or liver
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cancer without us being able to do anything about it. It became a disease the medical profession either feared or ignored. Much has changed in the last 40 years. The prevalence of hepatitis B in Australia has risen with an increase in the number of migrants from high prevalence countries, we have an effective vaccine and are aiming for universal coverage of children, we understand the epidemiology more and no longer think of people as being ‘healthy carriers’ but continue to monitor those with chronic hepatitis B life-long, and
HEPATITIS SA COMMUNITY NEWS 74 • August 2017
we have safe treatments that dramatically decrease the risk of cirrhosis and liver cancer. And most of this is done by GPs. We are the ones who need to be aware of those in our practice who may be at risk of hepatitis B and know how to screen them appropriately, who needs to be vaccinated, how to monitor people with active hepatitis B, and when and how to refer them to specialists for treatment. One in three people living with chronic hepatitis B in Australia remain undiagnosed, less than a third of contacts of
USEFUL RESOURCES HepBHelp: an independent website which aims to assist GPs in the further investigation and management of patients diagnosed with chronic hepatitis B. www.hepbhelp.org.au Hepatitis SA: provides information, education and support services to South Australians affected by hepatitis B and hepatitis C. This includes people with hepatitis B or C, their family and friends, and professionals who support them. For fast phone help you can call 1800 437 222. hepatitissa.asn.au people with hepatitis B have been vaccinated, one in four people with chronic hepatitis B will die from liver cancer or cirrhosis, and appropriate treatment can decrease this risk by 50%. No longer should we be ignoring or fearing hepatitis B. The interpretation of hepatitis B blood results may seem complex, and treatment options may appear confusing but there are good resources to help simplify them and guide us as to what to do. In order to fully protect our patients and our community we need to be sure we know where to find the right resources. Assoc Prof Jill Benson AM Medical Educator, ModMed With thanks to ModMed and SHINE SA.
Hepatitis Australia: Here is the quick reference guide I find handy to the hepatitis B virus, vaccines, transmission, prevention and disease course. www.hepatitisaustralia.com/hepatitis-b-facts/ SA Health viral hepatitis nurses: A team of Viral Hepatitis Support Nurses in SA provide advice to GPs on the management of patients with viral hepatitis, including assistance with referral to specialists. Patients may also speak to the nurses directly. Support is also available for people in country areas. Scroll down the page to view the video which explains the role of the viral hepatitis nurse. www.sahealth.sa.gov.au/hepatitisnurse ASHM GP management plan: No list would be complete without this tool. Download it at bit.ly/2umdZ6m ARTICLES: • J MacLachlan & B Cowie “Chronic hepatitis B: What’s new?” Australian Family Physician 2013; 42 (7):448451: This article discusses some of the key clinical questions that arise in the management of HBV, with a focus on actions that can reduce the impact of chronic hepatitis B on individuals and the community, and the recent developments that will have a substantial impact on the management of HBV in Australian general practice. www.racgp.org.au/afp/2013/july/chronic-hepatitis-b/ • Hepatitis B and Primary Care Providers - The role of primary care providers in hepatitis B diagnosis and management, ASHM bit.ly/2u6kJKu ModMed is a profit-forpurpose enterprise dedicated to improving lives through health education. Learn more at modmed.com.au. August 2017 • HEPATITIS SA COMMUNITY NEWS 74
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Australia Leads World in Hep C treatment
What’s behind its success?
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he Australian government has listed yet another drug to cure hepatitis C on the Pharmaceutical Benefits Scheme (PBS). The drug Epclusa—a combination of sofosbuvir 400mg and velpatasvir 100mg—is the first of the direct-acting antiviral treatments effective for all types of the disease. It will cost most patients A$38.80, and A$6.30 for concession card holders. Before the PBS listing, the cost exceeded A$20,000. A number of hepatitis C treatments have been listed on the PBS since March 2016. The government has committed to investing A$1 billion over five years to treat the 230,000 Australians living with the disease. Australia is a leading country in the global response to hep C. Since March 2016, around 40,000 people with hep C have had treatment. An estimated 95% of them have been cured. The World Health Organisation recently set ambitious goals for the “elimination of hepatitis C as a major public health threat”. These included
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having 80% of people treated and an 80% reduction in the spread of the virus by 2030. Given there are around 70 million people infected with hep C worldwide, only 20% diagnosed, and no effective vaccine, the task ahead is enormous. But Australia is impressively heading towards these targets and may present a model for other countries to adopt. A recent report by the Kirby Institute estimated Australia was on track to eliminate hepatitis C by 2026—four years earlier than the WHO goal.
Why are we doing this? The government has taken such a proactive approach to treating hepatitis C for several reasons.
The first is the large burden of serious liver disease, such as liver cancer and liver failure. A recent report from the Australian Institute for Health and Welfare showed rates of liver cancer increased five-fold from 1982 to 2013, with hep C the major cause. Nearly 1,500 Australians died from liver cancer in 20112012 and that number could
HEPATITIS SA COMMUNITY NEWS 74 • August 2017
more than double over the coming decade. Secondly, most people affected with hepatitis C are injecting drug users. Although Australia has led harm-reduction strategies, such as needle syringe programs and access to methadone for people who inject drugs, several thousand new infections continue to occur each year. A third reason is the appeal of the new direct-acting antiviral treatments themselves, which can cure 95% of people treated and have the capacity to prevent serious liver disease and spread of hep C. By contrast, treatments such as Harvoni (sofosbuvir plus ledipasvir) and Zepatier (grazoprevir plus elbasvir), which were added to the PBS in March 2016 and January 2017 respectively, are highly effective, but only active against one or two of the hep C strains. The latest treatment, Epclusa, is one tablet, to be taken daily, which combines two existing drugs – sofosbuvir and velpatasvir. It is highly effective against all six hep C strains, has a treatment
RIGHT: Epclusa tablets
duration of around three months and minimal side effects.
C treatment, who from March 2016 were able to prescribe the new treatments.
Another treatment effective for all the strains – which combines glecaprevir and pibrentasvir – is expected to be available in Australia in 2018. Treatment duration will be only two months for patients without advanced liver disease.
General practitioners and other non-specialists now write at least half of prescriptions for the new antivirals, with around 80% of treatments dispensed in community pharmacies.
What’s behind Australia’s success? Australia has managed to develop a program of unrestricted access to treat people with hepatitis C – all adults with hep C are eligible. Most countries have restricted access to those with more advanced disease. Many have denied access to people with ongoing drug and alcohol use. The key to this universal access was the Australian government’s capacity to negotiate much lower drug prices than in other high-income countries, following strong advocacy from the hepatitis C sector. For instance, Australia paid an estimated ten-fold lower price per patient treated in 2016 than did Germany. In December 2015, the government committed to providing sizeable funding for tackling hepatitis C for five years with a cap in expenditure and no cap in the treatment number. Australia also managed to involve non-specialists in hep
In almost all other countries, treatment of hep C is largely through specialist hospitalbased clinics. In many countries only specialists can prescribe. Australia’s history of GP involvement in HIV antiviral treatment and drug dependency treatment was an important foundation to build a concerted hep C education and training program on. Australia has also reached highly marginalised populations in large numbers. An estimated 20% of people who inject drugs have access to the new treatments, and numbers treated through the prison system are expanding rapidly. As mentioned, Australia has been a world leader in harm reduction for people who inject drugs (resulting in only 1% being HIV-infected), and has also led the world in evaluating the new treatments in this key population group. Most Australian jurisdictions are developing programs for new treatment access in drug and alcohol services and prisons. All these measures have provided the optimal framework for taking
Originally published at
advantage of the incredible curative potential of the hep C treatments and their capacity to improve quality of life, prevent advanced liver disease, and limit the spread of hep C.
How to sustain momentum
A key to ensuring momentum of the initial surge of hep C treatment will be ongoing screening of high-risk populations. These include people with current or past injecting drug use and immigrants from highprevalence countries, such as Egypt and Pakistan, where unsafe medical procedures have been responsible for most infections. In Australia, around 20% of people with hepatitis C remain undiagnosed. Finally, raising awareness through days like World Hepatitis Day and overcoming the stigma many people with hep C carry will be fundamental to success. The potential of revolutionary hep C treatments to empower the whole sector, together with continued advocacy and government support, should see Australia head towards elimination of the disease over the next decade. Greg Dore Professor of Medicine, Clinical Researcher and Epidemiologist, UNSW
: http://bit.ly/2wfHBo8 August 2017 • HEPATITIS SA COMMUNITY NEWS 74
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24th National Symposium on Hepatitis B and C Saturday 18th November 2017 International Speaker: Prof Jean-Michel Pawlotsky
Henri Mondor University Hospital & University of Paris-Est, Paris, France The 24th National Symposium on Hepatitis B & C will provide an update on the current management of chronic Hepatitis B and C. The symposium will provide lectures, panel discussions and interactive cases, which would provide general gastroenterologists, ID physicians and GPs with state of the art knowledge of how to treat HCV and HBV in primary and tertiary care settings.
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Free, confidential information and support on viral hepatitis:
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HEPATITIS SA COMMUNITY NEWS 74 • August 2017
Hepatitis E(urope)
H
epatitis E virus (HEV) infection is the most common cause of acute viral hepatitis worldwide: an estimated 3.4 million symptomatic cases have been reported. In developing countries, HEV causes large outbreaks amongst young adults. In most cases patients experience an acute self-limiting illness, but in pregnant women, immunosuppressed individuals and those with pre-existing liver disease there is a significant mortality rate. HEV has also shown an increasing incidence in Europe since 2010. Although it can be difficult to determine incidence rates because most HEV infections are asymptomatic or self-limiting, it is easier to measure in the more severe cases when HEV infection progresses from a relatively
Four samples of pork liver sausage infected with HEV
short-lived acute disease to a long-term chronic condition. Ahead of 2017’s World Hepatitis Day on July 28, a surveillance report on the incidence of HEV infection in Europe was published by the European Centre for Disease Prevention and Control (ECDC) . It shows real cause for concern: in a decade the reported incidence in Europe has grown ten-fold, from 514 cases in 2005, to 5617 cases in 2015. Additionally, testing, case definitions, diagnosis, and surveillance for HEV infection vary extensively across Europe, with not all nations actively monitoring their HEV infection rates. Most reported cases were in men older than 50 years, caused by genotype 3, and reported in the UK, France, and Germany, where surveillance is in place. Incidence also increased in countries without
a surveillance system, indicating that reporting of the incidence might not be the only reason for the surge in infections. The most obvious question to draw from this data is has there been a genuine rise in the number of new cases throughout Europe, or are greater awareness of HEV infection and better diagnostic techniques helping to boost measurement of a stable situation? A report from the European Food Safety Authority (EFSA) has shown significant evidence that most HEV infections in Europe are due to the consumption of undercooked or raw pork meat and, ironically, liver, which highlights the need for clearer guidance on how to safely prepare these foods, or else avoid them altogether. In the wake of World Hepatitis Day, the ECDC will now undertake a wider investigation. Consistent methods must be adopted throughout Europe to provide a better understanding of the burden of this emerging and under-recognised infection, and raise awareness about its transmission and treatment. More information can be found in The Lancet, at dx.doi.org/10.1016/S01406736(17)31922-0. The EFSA report can be read at www.efsa.europa.eu/en/ efsajournal/pub/4886.
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Living Books for As a part of the ‘LiverBetterLife’ pilot project, aimed at increasing the uptake of hepatitis C treatment in rural and regional communities, peer educators from Hepatitis SA joined forces with the Murray Bridge Public Library to bring books alive on the 31st May 2017. Our Living Books project was inspired by the Human Library (or ‘Menneskebiblioteket’ as it is called in Danish), developed in Copenhagen in 2000 as a part of an arts festival. The Human Library is a place where real people are on loan to readers, who hear their stories and can ask questions about their lives. Difficult questions are expected, appreciated and answered.
Hepatitis SA provided five Living Books for loan, each with an unusual and engaging story to tell (see over). I was involved in this event as one of the ‘living books’. We all shared true tales of our extraordinary lives with ‘readers’ who ‘borrowed’ us. As the Living Book ‘Rebel Girl’, I was amused to receive my own barcode from Tim Law, the wonderfully enthusiastic Team Leader at the Murray Bridge Library. We each had our own unique barcode, as we were now a part of the Murray Bridge Library Catalogue. It was quite daunting, and I didn’t feel anything like the fearless rebel girl that I had once been, as I waited nervously, wondering if I would be borrowed.
Murray Bridge Library’s Tim Law (in orange) and the Living Books
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HEPATITIS SA COMMUNITY NEWS 74 • August 2017
Torn between emotions of delight and nervousness, I was actually borrowed twice that day. Each time, I was taken to the counter by the borrower for my barcode to be scanned, as I was ‘checked out’ and ‘returned’ after finding a comfortable spot in one of the many reading nooks, for the borrower to listen to my story. All of the other Living Books were also borrowed by curious library members. We all agreed that the event was a great success, as each of our readers had provided us with wonderful feedback. The Liver Better Life project was based in Murray Bridge, South Australia and was funded by Hepatitis Australia. Lisa Carter
The Hepatitis SA Living Books Library What My Cat Told Me Mark Barbulovic From the media industry to community services via a rainbow, this is a story of a life, pre- and post-transplant surgery. Rebel Girl Lisa Carter Drawn to danger this Rebel Girl defies all odds to survive the debaucherous decades that were the 80’s and 90’s. The Holly Bible Carol Holly A Testament to testing and treatment. The memoirs of a woman living with a chronic illness and the impact this has had upon her life and identity.
Warrior & Champion: Never Say Die Karan Olson Opportunities were few and far between. Born to alcohol-dependent parents, she made a conscious decision not to follow their footsteps and to survive in other ways. Made a ward of the state by 10 years old she was too young for jail and too old to foster. With no faith in institutions or the system, made to feel as an outsider of our society, she chose to live as an outsider. This is a story of how one woman has stood up for those who have been failed, like her, and the many facets of healing. Some Things Are More Important Than $ Fred Robertson After migrating to a country full of promise, from happiness to tragedy, the promise was broken. This is a story of losing and winning, about family, friendships and the new promises of opportunity, health and contentment.
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Tackling Prison BBVs
A new approach to testing and treatment in SA’s prison system to reduce the impact of hepatitis B, hepatitis C and HIV in South Australian prisons and, accordingly, within the broader community to which people released from prison return, which is especially important when you consider that many people first contract BBVs when they are incarcerated.
Partnerships are imperative to build an effective statewide response to BBVs within the prison system. Prevention, testing, treatment and management of BBVs amongst SA’s prisoner populations is the shared responsibility of state government agencies, primary health services, public hospitals, Aboriginal health services, and nongovernment organisations. Minister Peter Malinauskas (second from right) with Hepatitis SA’s Shannon, Jen, Tess and Fred
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n the lead-up to 2017’s World Hepatitis Day, South Australia introduced its—and Australia’s—first Prisoner Blood Borne Virus Prevention Action Plan. The joint SA Health and SA Correctional Services plan was launched by Minister for Correctional Services, the Hon. Peter Malinauskas, on 24 July. The Action Plan, to be implemented between 2017 and 2020, aims to have all
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relevant services work in a coordinated effort to reduce the unacceptably high prevalence of blood-borne viruses (BBVs) in prisons. Up to 40% of prisoners have hepatitis C, compared to only 1% in the wider community, and 3-4% of prisoners have hepatitis B, compared to just under 1% in the wider South Australian community. This first plan outlines the State’s collaborative approach
HEPATITIS SA COMMUNITY NEWS 74 • August 2017
Activities in the Action Plan reflect the integration, teamwork and goodwill required to implement the necessary cross-departmental systems and processes needed to achieve stipulated goals. Strategies in the Action Plan to increase testing include proposals for optout testing for BBVs, and the possible introduction of rapid testing. Efforts will also be made to increase hepatitis C treatment and hepatitis B monitoring with a model of care that will see a more coordinated role for the Viral Hepatitis Nurses in providing
Kaurna elder Michael O’Brien and Hepatitis SA’s Kerry Paterson specialist support to prison nursing staff. An estimated 780 to 1050 South Australian prisoners live with hepatitis C. In the last six months, an impressive 150 were treated—a vast increase compared with previous years. Nonetheless there remain hundreds of others who can be treated and cured: a crucial part of preventing the spread of the virus both in prison and in the community. Kerry Paterson, Hepatitis SA’s EO, explained the plan’s urgency. “The billion-dollar investment in direct-acting antiviral (DAA) treatment for hepatitis C by the Australian government to treat all Australian adults, including prisoners, ends in 2021, and there is no guarantee that a similar arrangement will be put in place afterwards. This means that now is the time to scale up HCV treatment in our prisons!
“We have good foundations on which to build, so I hope that we will make the most of our opportunities, and continue to have goodwill, courage and determination as we implement some of the more challenging actions set out for us in this Action Plan over the next three years.” Andrew Wiley, Nursing Director of SA Health’s SA Prison Health Service, expanded on the importance of the DAAs. “The new DAAs provide a significant improvement over previous treatments, which often took a significant amount of time as well as having side effects. The new treatments are much better, with minimal side effects – this is a significant advancement in treatment, and so treating prisoners in larger numbers is now a practical option. “The changes in protocols also mean that most prisoners do not need to see a
specialist or have any scans, so they do not have to go out of prison or transfer prisons to commence treatment, which significantly increases uptake. For those that require scans, these are now completed with Fibroscan clinics at each prison. In addition, those few patients that need to consult with a specialist can now do so via video conference, which ensures access to the best specialists in SA without having to move outside of the prison. “Australia is uniquely placed to effectively treat hep C in the prisoner population, and is something that most other countries are unable to support to the same scale. Australia is poised to be a global leader in this area.”
Hear Hepatitis SA educator Shannon Wright and Education Coordinator Tess Opie discuss the plan and its implications on Radio Adelaide, at bit.ly/2vZq175. The plan itself can be downloaded at bit.ly/2fDVOYb. August 2017 • HEPATITIS SA COMMUNITY NEWS 74
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Healthy Lunch Packs ROUN D-UP
Drug ARM Development Drug ARM, who work to improve the lives of those who are experiencing harms associated with alcohol and other drug use, have been a great advocate of World Hepatitis Day, with particular thanks to champions of the cause like Debby Kadarusman. One of the World Hepatitis Day events this year included a workforce development session for Drug ARM Volunteers. Shannon from Hepatitis SA’s Education Team talked about all aspects of viral hepatitis to more than a dozen of their keen volunteers, who were feverishly taking notes. Peer Educator Fred gave his lived experience perspective of hepatitis C to the group, and Michelle, Hepatitis SA’s Clean Needle Program Coordinator, provided harm reduction information, talked about the importance of CNP services, discussed specialised injecting equipment and how to engage with people who inject drugs. Drug ARM utilised funds from a small grant from Hepatitis Australia to provide a deliciously healthy lunch and other goodies.
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School lunches are a challenge for most parents. That challenge is all the greater when you’re a recent immigrant from a culture different to that of the prevailing environment. How do you pack nutritious, culturally-familiar food which are easy to handle and “socially-acceptable”? For their World Hepatitis Day small grant activity this year, the Didis group from the Bhutanese community presented five school lunch ideas which has worked for their members. The five Didis who each presented a nutritious and delicious lunch said the packs were well-accepted by their children and in some cases, by their friends as well. On the menu were sandwiches, fried rice, noodles, dumplings and flat bread and vegetables. Useful tips included keeping things simple such as the sandwiches and noodles, and cooking in bulk on the weekend such as the dumplings and flat bread. The presentations were recorded on video which the Didis hope to later use as an education tool for new arrivals. ABOVE: Drug ARM’s healthy liver lunch RIGHT: Uniting Communities Pamper Day ABOVE OVER: St Bernards Volleyball Association BELOW OVER: Big Issue Street Soccer’s WHD match
HEPATITIS SA COMMUNITY NEWS 74 • August 2017
Pamper Day for Carers in Murray Bridge Carers in Murray Bridge enjoyed a pamper day as they learnt about viral hepatitis during a small grant activity organized by the local Uniting Communities. The group shared conversations about people they knew who had received the new hepatitis C treatments, and completed a simple hepatitis quiz.
Big Issue, Soccer & WHD St Bernards Goes Beyond the Club St Bernards Volleyball Association (SBVA) has a membership of some 70 players and supporters with people from a wide range of cultural backgrounds including Afghani, Bangladeshi, Pakistani, Pacific Islanders, Malaysian and Indian to name a few. The club also has many members from refugee backgrounds. As part of its World Hepatitis Day 2017 small grant activity this year, SBVA not only distributed blood rules information to members to raise awareness about hepatitis and blood-borne viruses, but also posted information on the notice board and in the foyer of the school where they play. Student captains at the school were informed about the posters and the information. In addition to buying prizes for their World Hepatitis Day quiz on 27 July, the club purchased a full medical kit to enable them to treat player injuries. Thirteen of the 22 quiz participants got correct answers to all the questions. Left-over quiz sheets were included in the club’s following newsletter. As in previous years, excess information packs were taken for further distribution by one of the club members who worked at a clinic at Murray Bridge.
The Big Issue Community Street Soccer Program held an event for World Hepatitis Day this year with a successful application for funds from the Hepatitis Australia Small Grants Fund. The activities took place in the South Parklands on the 26th of July. Big Issue workers Matt and Shannon put on a healthy barbeque and salad feast after a spirited match between the street soccer players, which was enjoyed by all in attendance. Lisa from Hepatitis SA presented information to the group, speaking about viral hepatitis, transmission, eating well for your liver, and information about the latest hepatitis C treatments. The players then answered questions relating to viral hepatitis for prizes that included sporting equipment and World Hepatitis Day promotional items. Everyone there felt like winners that day, with the recent news that two of the local players have been selected from the Adelaide Community Street Soccer Program to play in this year’s Homeless World Cup, which will take place in Oslo, Norway, from 29 August to 5 September. For more information on the Homeless World Cup, see bit.ly/2uEW5gd.
August 2017 • HEPATITIS SA COMMUNITY NEWS 74
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Women & Pregnancy These resources, and many others, are listed in our online catalogue at hepatitissa.asn.au/library. To browse the complete collection of publications that are relevant to pregnancy, babies and beyond: go to the library page and scroll down to the quick links, click on ‘Groups and Settings’ and then on ‘Women and Pregnancy’. They are all free to download, but if you don’t have access to internet or printing please contact us on 8362 8443 and we’ll assist you with obtaining copies.
Antenatal testing and blood-borne viruses (BBVs)
Alcohol, tobacco and other drugs during pregnancy
Australian Society for HIV Medicine (ASHM), Sydney, 2015. 10p.
National Drug and Alcohol Research Centre, Sydney, 2014. 8p.
This resource is for health professionals providing women with antenatal care, including midwives, general practitioners and obstetricians. It contains advice about recommended antenatal testing for hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency virus (HIV). In addition, it provides information about the management of these BBVs during pregnancy and at delivery.
This factsheet will answer questions about whether different drugs are safe to use during pregnancy, safe to stop during pregnancy, the effects they can have during pregnancy, the effects they can have on the baby, and whether it is safe to use different drugs during breastfeeding.
bit.ly/antenatalbbvtesting
bit.ly/atod_pregnancy Delivery method, breastfeeding did not impact mother-to-infant HCV transmission risk Review of article in Annals of Internal Medicine via Helio Hepatology News, Thorofare NJ, 2012. Results from a recent systematic review indicate no clear associations between the risk for mother-to-infant HCV transmission and breastfeeding practices, labor management or method of delivery. bit.ly/motherinfanttrans_ norisk
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HEPATITIS SA COMMUNITY NEWS 74 • August 2017
Pregnancy, birth and beyond: a resource for women about hepatitis C. Hepatitis SA, Adelaide, 2016. 20p.
Prevention of motherto-child (perinatal) transmission of hepatitis B University of Washington, Washington, 2016. Online case-based modules. Free education modules for health care workers involved with the care of patients with hepatitis B infection and patients at risk for infection with hepatitis B. Covers transmission risks, prevention, management in different situations and treatment options. bit.ly/preinataltrans_ casebasedmodules
how recent developments in HCV therapy might impact prevention of HCV vertical transmission. bit.ly/verticaltrans_daas Hepatitis B and mothersto-be Hepatitis SA, Adelaide, 2017. 3-fold brochure Brief information about Hepatitis B transmission, testing, treatment and how to protect yourself, your baby and your family. Also available in Vietnamese and Chinese. Free print copies available: call 1800 437 222.
What is hepatitis C? Hepatitis C is a virus that causes inflammation of the liver which may lead to liver disease in some people.
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Free print copies available: call 1800 437 222. Hep C, pregnancy and babies Hepatitis SA, Adelaide, 2016. 3-fold brochure. Brief information about transmission risks, testing procedures for mother and baby and breastfeeding. Also contains a list of services that are available from Hepatitis SA. Free print copies available: call 1800 437 222 .
Hepatitis SA is a non-p rofit community based organisation established to provide information and support to people affected by hepatitis C. Hepatitis SA provides: • a telephone information and support line on 1800 432 777
� Hepatitis B be Mothers to
• printed information on hepatitis C • referrals to relevant services • support group servic es • positive speakers who can share their personal hepatitis C exper iences • information and educa tion sessions for community, and health and community workers • peer education servic es • advocacy for the needs of people affected by hepatitis C
titis B Birth dose of hepa At birth (within 12Other information on transmission : hours) Hepatitis C is not define d as ine a sexually of hepatitis B vacc transm2nd dose itted diseas e. It is not commonly 2 months transmitted through sex. vaccine B Risk increases if an STD 3rd dose of hepatitis 4 months such as genital herpes is present. Wom en should have safe sex durin ine titis B vacc g mens truation. 4th dose of hepa 6 months
All images © r8r (www.f lickr.com/photos/r8r)
Vertical transmission ation? ll need vaccin of hepatitis C: towards Does baby sti universal antenatal screening in the era of new direct acting elf? e care of mys How can I tak (DAAs)? antivirals
A resource for all women with hepatitis C, their families, friends and healthcare providers. Covers the possible effects of hepatitis C on a pregnancy, self-care, birth options, transmission, breastfeeding and other associated issues.
Hep C, Pregnancy & Babies
Journal of Virus Eradication via HCV Action, UK, 2016. Call the Hepatitis SA Help line on 3p. 1800 437 222on re Informati for more information. Mo
pline 1800 437 Hepatitis SA Hel sn.au www.hepsa.aPh
This article gives a brief atitis B... I don't have hep analysis, using the cination? Do I need vac example of Switzerland, of is e hepatitis B, it w you don't hav If test results sho antibodies w if you have the B is important to kno atit sible hep you against pos r which protect unity, talk to you don't have imm to get infection. If you d time for you goo a is n whe doctor about vaccinated.
to this program contributed funds update: Jan 2017
Hepatitis SA
1800 437 222 or (08) 8362 8443 Fax (08) 8362 8559 r 3 HackneySca to hea Rd nHack ney SA 5069 PO Box 782 orm on Town SA 5071 inf Kentati www se a.asn.au ine.heps in Ch
PO Box 782, Kent
Adil Soh-Lim
SA Health has contributed funds towards this Program. Last update: May 2016
Town SA 5071
Microbiology Department of ultation with the Hospital. Developed in cons en's and Children's Diseases, Wom and Infectious
Illustrations ©
SA Health has
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August 2017 • HEPATITIS SA COMMUNITY NEWS 74
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Affected by hep
Affected by hepatitis C? Photo © S. Allen
Calming the C • Information and support in a confidential, friendly environment • Speak to others who have had treatment • Partners, family and friends welcome
Now meeting at HACKNEY, ELIZABETH HACKNEY PORT ADELAIDE and PORT ADELAIDE Wonggangga Turtpandi, 3 Hackney For Rd information, phone 8362 8443 Church St & Dale St 12.30–2.30pm See over forcnr dates 12–2pm • Tuesday, 29 August • • • •
Tuesday, 26 September Tuesday, 24 October Tuesday, 21 November Tuesday, 19 December
• • • • •
Tuesday, 22 August Tuesday, 19 September Tuesday, 17 October Tuesday, 14 November Tuesday, 12 December
Hepatitis C peer educators are also available to provide information and support to clients at the following services: DASSA Central Services Hepatitis C Treatment Clinic 91 Magill Rd, Stepney Tuesdays 9–12am DASSA Central Pharmacy Thursdays 9–12am • Information and support in
Calming friendly environment
DASSA Southern Service • Speak to others who have h 82 Beach Rd,• Partners, family and friends Christies Beach Monday monthly 10am–1pm Upcoming dates: Now meeting at HACKNE Ring Lisa on 8362 8443 and PORT ADELA for details
For information, phone DASSA Northern Service See over for da 22 Langford Dr, Elizabeth Thursday fortnightly 10am–12pm Upcoming dates: Ring Lisa on 8362 8443 for details
Hutt Street Centre 258 Hutt St, Adelaide Wednesday weekly 10am–12.30pm WestCare Centre 17 Millers Court (off Wright St), Adelaide Wednesday weekly 10.30am–12.30pm
Useful Services & Contacts Hepatitis SA Free education sessions, printed information, telephone information and support, referrals, clean needle program and library. (08) 8362 8443 admin@hepatitissa.asn.au www.hepsa.asn.au Hepatitis SA Helpline 1800 437 222 (cost of a local call) Adelaide Dental Hospital A specially funded clinic provides priority dental care for people with hepatitis C with a Health Care Card. Call Hepatitis SA on 1800 437 222 for a referral. beyondblue Mental health information line
Hutt St Centre Showers, laundry facilities, visiting health professionals, recreation activities, education and training, legal aid and assistance services provided to the homeless.
P.E.A.C.E. HIV and hepatitis education and support for people from nonEnglish speaking backgrounds.
258 Hutt St, Adelaide SA 5000 (08) 8418 2500
SA Sex Industry Network Promotes the health, rights and wellbeing of sex workers.
Lifeline National, 24-hour telephone counselling service.
(08) 8351 7626
13 11 14 (cost of a local call) www.lifeline.org.au
SAMESH South Australia Mobilisation + Empowerment for Sexual Health www.samesh.org.au
Mental Health Crisis Service 24 hour information and crisis line available to all rural, remote and metropolitan callers. 13 14 65
1300 224 636 www.beyondblue.org.au
MOSAIC Counselling Service For anyone whose life is affected by hepatitis.
Clean Needle Programs in SA For locations visit the Hepatitis SA Hackney office or call the Alcohol and Drug Information Service.
(08) 8223 4566
1300 131 340 Community Access & Services SA Alcohol and drug education; clean needle program for the Vietnamese and other communities. (08) 8447 8821 headspace Mental health issues are common. Find information, support and help at your local headspace centre 1800 650 890 www.headspace.org.au
Nunkuwarrin Yunti An Aboriginal-controlled, citybased health service with clean needle program and liver clinic.
(08) 8245 8100
Youth Health Service Free, confidential health service for youth aged 12 to 25. Youth Helpline: 1300 13 17 19 Parent Helpline: 1300 364 100 Vincentian Centre Men’s night shelter run by St Vincent de Paul Society. Assistance hotline: 1300 729 202
(08) 8406 1600 Viral Hepatitis Community Nurses Care and assistance, education, streamlined referrals, patient support, work-up for HCV treatment, monitoring and follow-ups. Clients can self-refer. Contact nurses directly for an appointment. Central
Margery - 0423 782 415 margery.milner@health.sa.gov.au Jeff - 0401 717 953 North
Lucy - 0401 717 971 Trish - 0413 285 476 South
Rosalie - 0466 777 876 rosalie.altus@fmc.sa.gov.au Emma - 0466 777 873
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HEPATITIS SA COMMUNITY NEWS 74 • August 2017
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